POZ Community Forums
Main Forums => Living With HIV => Topic started by: mikeyb39 on April 26, 2013, 12:08:20 am
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Here recently i have just had zero amount of energy. I've been working a lot getting up at 430am. I want to think the problem is sleep. I just don't know what to do. i've discussed it with my doctor and i've been taking ambien and it helps me fall asleep, but only for about a few hours then im back up again.
I literally crash at work around lunch time, which for me is about 11am, i could just crawl under the desk and sleep for hours it feels like. I get hot flashes like i'm going thru a mid-life crisis.
I have another doctor appointment next week for labs, i'm going to have him check things again. Maybe i need something different than the ambien to allow me to sleep thru the night
This may be too much information, but my sexual desire has disappeared, i don't even have the energy to go out and meet folks
i take my multi vitamins, eat pretty well, exercise, but i feel like i'm going to fall over sometimes, I really do.
i'm I the only one in this situations. how should i fix it,
please give me some thoughts.
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I have zero energy too, but I'm depressed right now and in a rut I can't seem to get out of. Everything seems overwhelming and I save my energy for things I have to do like food shopping.
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My energy levels have crashed in the few years. Yep, it could be getting older, but I think it's far more likely to be HIV related. I noticed that when I started taking treatment the fatigue became far worse, and I've never really recovered. I have better moments but on the whole, I'm pretty shattered most of the time. I've discussed it with my doctor, who ran some tests and the only one that came back as abnormal was vitamin D, so I was given a shot for that and also take supplements. It's possibly made a small difference, so perhaps this might be worth speaking to your doctor about, but don't expect miracles.
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My energy levels have crashed in the few years. Yep, it could be getting older, but I think it's far more likely to be HIV related. I noticed that when I started taking treatment the fatigue became far worse, and I've never really recovered. I have better moments but on the whole, I'm pretty shattered most of the time. I've discussed it with my doctor, who ran some tests and the only one that came back as abnormal was vitamin D, so I was given a shot for that and also take supplements. It's possibly made a small difference, so perhaps this might be worth speaking to your doctor about, but don't expect miracles.
I had the same problem with low vitamin D and the doctor told me to take vitamins for it. You can get it from the sun but if you have no energy you don't want to go out. I tired a B12 shot and that only gave me energy for a day or so. I always take a multiple vitamin anyway with my meds.
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Are you still taking Isentress? Have you thought about monotherapy which in your case would mean continuing on your current regime but dropping Isentress? One less drug for your body to process could make a difference. Might be worth discussing this with your doc.
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Are you still taking Isentress? Have you thought about monotherapy which in your case would mean continuing on your current regime but dropping Isentress? One less drug for your body to process could make a difference. Might be worth discussing this with your doc.
Why would you ever be so careless as to suggest a monotherapy for the treatment of HIV? If you don't know what you are talking about, you should not be giving advice to others. I suggest you educate yourself on proper HIV treatment guidelines.
Joe
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Why would you ever be so careless as to suggest a monotherapy for the treatment of HIV? If you don't know what you are talking about, you should not be giving advice to others. I suggest you educate yourself on proper HIV treatment guidelines.
Joe
''Boosted darunavir monotherapy works well in two studies''
http://www.aidsmap.com/Boosted-darunavir-monotherapy-works-well-in-two-studies/page/1435288/
My viral load has remained suppressed for more than 18 months on darunavir/norvir monotherapy and, germane to this thread, within a few days I felt a lot less wiped out than when I was on combination therapy.
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Prezista Monotherapy- thats interesting, please keep us updated :)
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Suggesting monotherapy is a bit dramatic for someone who is experiencing fatigue. Kind of like killing an ant with a sledge hammer.
Start by finding a cause.
Get your testosterone levels checked.
A cbc to make sure you are not anemic.
Ask for a thyroid panel. Make sure they test total t4 and tsh (low thyroid can cause fatigue and occurs more often in hiv positive people, speaking from experience).
There are also a number of illnesses and conditions that can cause fatigue. It may take some time to find the cause. I would try and be more analytic then just jumping to change meds straight away.
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hi all,
thanks for the responses. My doctor already has me taking one less med already, I don't think i want to push it, plus i'm doing ok with the combo.
I really think my issue is due to not getting enough rest/sleep and being stressed out with work or overwork i might say. I know i have some depression a bit as well, so that may also be playing a factor as well.
i'm going to discuss on weds with the doc, i've heard of the antidepressant trazadone that also is a sedative, so maybe i will give that a shot especially if it allows me to sleep thru the night.
I don't think my testosterone is an issue, at least it wasn't a year ago when he tested it. My friend has to take the shots and says it doesn't give him a ton of energy, it just makes him horny all the time. Horny is the least of my worries i just want to feel like getting out and doing things.
today wrapped up a week before vacation next week, so plan on getting some rest. gonna go to Augusta GA to visit a friend middle of next week, so that maybe will do me some good to get out of town for a few days.
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''Boosted darunavir monotherapy works well in two studies''
http://www.aidsmap.com/Boosted-darunavir-monotherapy-works-well-in-two-studies/page/1435288/
My viral load has remained suppressed for more than 18 months on darunavir/norvir monotherapy and, germane to this thread, within a few days I felt a lot less wiped out than when I was on combination therapy.
Zohar,
You still don't understand. You are not on a monotherapy if you are takiing duraunavir + norvir, as that is two drugs. You are still on a combo, just not on a triple or more therapy.
Joe
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Zohar,
You still don't understand. You are not on a monotherapy if you are takiing duraunavir + norvir, as that is two drugs. You are still on a combo, just not on a triple or more therapy.
Joe
I'm sorry, but you are misinformed. As the headline and the article show (cited again below), darunavir and norvir prescribed together are known as 'monotherapy' because, in spite of being a two drug regimen, the norvir at the dose its used here, is given specifically as a darunavir booster, rather than for its antirviral activity.
''Boosted darunavir monotherapy works well in two studies'
http://www.aidsmap.com/Boosted-darunavir-monotherapy-works-well-in-two-studies/page/1435288/
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Prezista Monotherapy- thats interesting, please keep us updated :)
Hi, As I said above I've been on it for over 18 months now and have consistently remained undetectable. Truvada just didn't agree with me and not only would I feel shattered but friends would comment on how worn out I looked. Literally, within around 48 hours of dropping Truvada I felt so much better -like a constant hangover had lifted. The fatigue I experience now tends to be episodic, whereas before it was ever-present. So boosted darunavir monotherapy definitely seems to be the most suitable option for me.
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12 hours ago you sure were singing from a different hymnal (http://forums.poz.com/index.php?topic=48377.msg586474#msg586474).
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12 hours ago you sure were singing from a different hymnal (http://forums.poz.com/index.php?topic=48377.msg586474#msg586474).
To clarify, when I was on combination therapy my energy levels were far, far lower than when I switched to monotherapy. I do still get tired now, but it's less constant and more manageable.
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I'm sorry, but you are misinformed. As the headline and the article show (cited again below), darunavir and norvir prescribed together are known as 'monotherapy' because, in spite of being a two drug regimen, the norvir at the dose its used here, is given specifically as a darunavir booster, rather than for its antirviral activity.
''Boosted darunavir monotherapy works well in two studies'
http://www.aidsmap.com/Boosted-darunavir-monotherapy-works-well-in-two-studies/page/1435288/
I'm not misinformed, I just believe it is important to fully describe a treatment regime and using the word "monotherapy", until it becomes widely known as possibly including a booster, still indicates a single drug regime. Words matter and my only goal is for us to be very clear in what we say, because many readers do not ask questions, so offering confusing definitions of terms is not a good way to share information.
I never discounted your experience, I only seek to be clear as to what we are specifically talking about. If you had initially said a boosted-monotherapy, we wouldn't even be having this exchange.
Joe
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Sorry to hear about your energy problems. Have you considered Ambien may be a culprit? I often hear friends say they just can't sleep, even though they're on the drug. They say they will be wide awake, usually about 3-4 hours after taking the med.
I know there was a recent report saying the drug may last longer in some, than originally thought. So, while you're up at 4:30, perhaps the drug is still working on you well into the lunch hour? Do any of your HIV meds increase the levels of Ambien?
I found something interesting on the Mayo Clinic website. I didn't realize most of the sleep drugs only help you fall asleep and don't help you stay asleep. It breaks down the drugs that do that, as well as the ones that help you fall asleep and stay asleep.
Just a thought.
http://www.mayoclinic.com/health/sleeping-pills/SL00010
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I had the worst hangovers on ambien. Plus, I would wake up in the middle of the night with my mind racing. Switching to a low dose of Klonopin and herb seems to do the trick most nights.
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a low dose of Klonopin and herb seems to do the trick most nights.
Sounds divine
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I'm not misinformed, I just believe it is important to fully describe a treatment regime and using the word "monotherapy", until it becomes widely known as possibly including a booster, still indicates a single drug regime. Words matter and my only goal is for us to be very clear in what we say, because many readers do not ask questions, so offering confusing definitions of terms is not a good way to share information.
I never discounted your experience, I only seek to be clear as to what we are specifically talking about. If you had initially said a boosted-monotherapy, we wouldn't even be having this exchange.
Joe
I used the term 'monotherapy' because that's what my drug regimen is officially known as - and as I've pointed is technically correct.
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I used the term 'monotherapy' because that's what my drug regimen is officially known as - and as I've pointed is technically correct.
But you're not using "monotherapy" in a correct context. To say "monotherapy" to most people would mean, oh say, I'm just taking Reyataz and nothing else. While the Norvir you are using is a booster, it is still two drugs.
Mikey, I agree with getting your thyroid checked. I had hypothyroidism and was dragging all the time. Plus had thinner hair. Not that this is definitely the cause of your fatigue, but it could be worth a shot.
I also have low energy and wake up in the middle of the night, up for a while, but do not take Ambien or any sleep aid. I was waking up between 3-4:30 am and was up for the day, but since going on a different med (Stribild) and getting rid of a combo that included Isentress, that has subsided. But I do still wake up and have low energy during the day. However, on my days off I rarely get up as early as I do when I have to work, so I am able to catch up on sleep then.
The Trazadone is a good option to try to see if it will help with your sleep issues. And I hope when you're on vacation you're able to rest and be less stressed. Good luck!
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Sorry you're having a tough time.
Your symptoms (lack of sleep, lack of sex drive, loss of interest, anxiety) could be attributed to depression. And Ambien is known to worsen depression in some people. That might be worth looking into.
Good luck.
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I have the same problem and it only started after I went on meds. In your case I think stress and lack of sleep might be making it worse. This might sound silly- but before you go to sleep try to tell your body to relax and clear your mind. If you go to bed with a whole days stress you are bound not to get good sleep. Sometimes this helps me get better sleep (and chamomile tea). Of course your doctor should check your tsh etc - which I'm going to do next time as well.
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But you're not using "monotherapy" in a correct context. To say "monotherapy" to most people would mean, oh say, I'm just taking Reyataz and nothing else. While the Norvir you are using is a booster, it is still two drugs.
Actually, I am correct, and like the poster above who has taken issue with the word, it's you who is mistaken. A protease inhibitor boosted by another drug is called 'monotherapy'. You may not agree with its use in that context, but that doesn't mean it isn't both technically and officially correct. Here is yet another link from a respected source which discusses 'monotherapy' in the same context that I've used it in:
''Protease inhibitor monotherapy in clinical practice: valid option for undetectable patients''
''Patients prescribed protease inhibitor-ritonavir (PI/r) monotherapy in ‘real-world’ clinical practice achieve viral suppression rates equivalent to those seen in randomised controlled trials, according to two surveys presented to the second BHIVA/BASHH joint conference in Manchester.''
http://www.aidsmap.com/Protease-inhibitor-monotherapy-in-clinical-practice-valid-option-for-undetectable-patients/page/1438593/
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Actually, I am correct, and like the poster above who has taken issue with the word, it's you who is mistaken. A protease inhibitor boosted by another drug is called 'monotherapy'. You may not agree with its use in that context, but that doesn't mean it isn't both technically and officially correct. Here is yet another link from a respected source which discusses 'monotherapy' in the same context that I've used it in:
''Protease inhibitor monotherapy in clinical practice: valid option for undetectable patients''
''Patients prescribed protease inhibitor-ritonavir (PI/r) monotherapy in ‘real-world’ clinical practice achieve viral suppression rates equivalent to those seen in randomised controlled trials, according to two surveys presented to the second BHIVA/BASHH joint conference in Manchester.''
http://www.aidsmap.com/Protease-inhibitor-monotherapy-in-clinical-practice-valid-option-for-undetectable-patients/page/1438593/
Zohar,
You are too fixated on "technical terms" to understand what I am saying. While it may be technically correct that you are taking a monotherapy, the use of the word, historically has always meant one drug. The only clarification Betty and I were trying to make is you may be confusing readers. This isn't about being right or wrong, it's about being clear in what we tell folks and to suggest that a boosted-monotherpay is not more than one drug, is also incorrect. As the terminology changes, folks will become aware of new therapies, but until that happens, monotherapy generally refers to a one drug treatment.
I just don't understand your refusal to refer to your regime as a boosted-monotherapy which is technically what it is and no matter the technical name, it still involves two drugs. Our goal here is to help folks understand treatment options and using confusing terminology helps no one.
Joe
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Zohar,
You are too fixated on "technical terms" to understand what I am saying. While it may be technically correct that you are taking a monotherapy, the use of the word, historically has always meant one drug. The only clarification Betty and I were trying to make is you may be confusing readers. This isn't about being right or wrong, it's about being clear in what we tell folks and to suggest that a boosted-monotherpay is not more than one drug, is also incorrect. As the terminology changes, folks will become aware of new therapies, but until that happens, monotherapy generally refers to a one drug treatment.
I just don't understand your refusal to refer to your regime as a boosted-monotherapy which is technically what it is and no matter the technical name, it still involves two drugs. Our goal here is to help folks understand treatment options and using confusing terminology helps no one.
Joe
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Doctors, including my own, scientific journals and respected sites such as AIDSmap all use the term monotherapy in the way that I have so if what you say is accurate (some external references would be useful to support your claims) then perhaps the public have some catching up to do. Also, in my first post that referred to monotherapy, I said it would mean dropping one of his drugs, which would have still left two for anyone who was checking the OPs signature, as I did, and how I knew that his regimen would be suitable for being converted to monotherapy. I haven't, as you claim, in any posts implied that boosted monotherapy is 'not more that one drug'.
Several posts back you stated that I'm not on monotherapy, and I have now demonstrated - with links to my references - that I am. If, as you say, the goal here is to help people understand treatment options then people reading this should now be (more) educated about what monotherapy actually is as opposed to what they think it might be.
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I think your sleep may be the cause of the low energy and I highly recommend trazadone. It gives me 7 to 8 hours of sleep a night...ambien gave me panic attacks...it could also be depression or anxiety...that is what exhausts me and the crazy bizarre dreams I have on atripla....but next week I'm switching to complera...I hear it is better in terms of the dreams.
But do ask about trazadone...it puts me out in about 10 minutes...and I was having horrible problems with insomnia.
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i've been taking ambien and it helps me fall asleep, but only for about a few hours then im back up again.
Like PAGuy said above,
Have you ever tried trazodone?
http://forums.poz.com/index.php?topic=47049
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Hi all, thanks for the responses.I went to the doctor he did my labs, thyroid and seems like everything else. I mentioned the trazadone and he said that is something I can consider on next visit, but he doesn't want me on Wellbutrin and trazadone at same time. I will need to taper of Wellbutrin first
He thinks lot of mine is stress and work if he had to put a finger on it
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I've always had zero energy I sleep all day, I feel tired 24/7 I'm currently not on medications but this no energy feeling sucks. I feel like I have no life and im only 24 years old also I have noticed that i have no interesting in speaking to people and rather be alone i get annoyed and upset quickly and just snap I don't know if its the hovering anger from what happened to me to lead me to this point or its just the depression that I have kept this a secret since 2009 I am a rape victim and currently seeking justice of that person whos currently out ruining every other females life. Sorry off topic but wanted to get it off my chest :-\ :-[
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Hi all, thanks for the responses.I went to the doctor he did my labs, thyroid and seems like everything else. I mentioned the trazadone and he said that is something I can consider on next visit, but he doesn't want me on Wellbutrin and trazadone at same time. I will need to taper of Wellbutrin first
He thinks lot of mine is stress and work if he had to put a finger on it
Hey Mikey,
I'm confused on why you doctor wants you off your Wellbutrin, before he will prescribe Trazadone. I suffer from depression and anxiety and I've been taking Wellbutrin, Citalopram and Trazadone for years with no issues. Trazadone serves to help keep you asleep and it has a 4 hour half-life, meaning within 8 hours the drug is pretty well out of your system. I like it because I don't wake up groggy or feeling hung-over, like I did with sleeping pills.
Unless your doctor has psychiatric training, I would suggest you speak with a psychiatrist and explain your issues and see what they recommend. It makes no sense to me, to have you drop the Wellbutrin, which I assume you also need, just so you can take Trazadone. The drugs work fine together and I simply can't understand why you cannot take both.
Joe
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Have you considered a sleep study to rule out sleep apnea?
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Mikey, I agree with Joe about the Wellbutrin and Trazadone. I've taken both before with no ill effects. You should, as Joe encouraged, talk with a psychiatrist before going off the Wellbutrin, especially if it has your depression under good control.
Betty
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well I'm not being completely honest , my doctor said he would let me try it, but when he told me it could cause priaprism (erections that don't go away), it scared me off. i Know its a rare side-effect, but i have bad luck with side-effects, i would die if i had to go to the doctor to get that taken care of.
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Hey - Mike - Some people have trouble falling asleep and some are early risers. I became an early riser when using Welbutrin. I'd fall asleep around 11 and wake up about 4:30. Then, like you I'd want to fall asleep around 2:30. My brother had the same experience but he worked in food service and would take a short nap in the afternoon before he left for work.
Are you taking the Welbutrin in the morning or before you go to bed? There are two types: extended release and sustained release. I tried to ascertain which one lasts longer but I couldn't. You might want to check with your Dr. and maybe switch to the one which has the shorter release time.
Think back and try to remember when you started having trouble falling asleep. I know when I've taken antidepressants I prefer the ones that help make me sleep.
I don't think anyone else mentioned this but it could be the culprit.